The Patient Protection and Affordable Care Act

Introduction

The Patient Protection and Affordable Care Act (PPACA), referred to as Obamacare or Affordable Care Act (ACA), stands out as one of the landmark reforms in the healthcare system of the United States over the last four decades. This act puts in place the basic legal protections in healthcare that have for a long time been absent. This is to an extent leading to nearly universal access to affordable healthcare from the time of birth all the way through death.

Some of the most compelling reasons that pushed for the creation of this Act include the following: At the time of its proposal, the US was facing difficult economic problems in the form of the 2007/2008 economic recession which was threatening to cripple a lot of its industries including healthcare. More so, the system of healthcare at the time was falling short of its potential, an issue that had lasted for far too long. Finally, the large spending on healthcare was not translating into better outcomes for patients.

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Signed into law by President Obama in 2010, the ACA has resulted in a number of changes that have transformed the healthcare system despite the act proving to be highly controversial in nature. It is this controversy that has resulted in various forms of debates among those who are in support of its integration in the context of healthcare versus those who oppose it. The main focus of the debates has always been in regard to its impact.

The supporters of the healthcare reform act assert that its impact is beneficial. Meanwhile, those against it argue that its impact will be harmful in the end. This paper sets out to explicate the implications of the ACA on the system of healthcare and the key stakeholders in it. It will look at these implications from both sides of the debate, therefore, demonstrating both its positive and negative implications.

Proposed Study

The passage and subsequent implementation of the ACA were carried out with the aim of introducing much-needed reforms in the US healthcare system. Some of the suggested implications for this healthcare act included carrying out a transformation of the non-group insurance market, mandate US citizens to get health insurance coverage, and reduce and reorganize healthcare spending under Medicare. Consequently, when fully implemented the ACA was expected to bring about a dramatically different healthcare landscape. The financial implications were projected by the Congressional Budget Office (CBO). The most significant projections included the capacity of the ACA to extend health insurance coverage to approximately 32 million people (Obama, 2016).

Further, the act was expected to raise federal government spending by close to $1 trillion over the next 10 years while concurrently raising revenues and reducing spending in a manner that would result in the reduction of the federal budget deficit (Obama, 2016). Five years following its implementation, the ACA has forged a path for a large number of shifts in the healthcare industry. In financial terms, this shift has represented close to 18% of the country’s gross domestic product (GDP).

The proposed study seeks to evaluate the ACA and determine its implications. This will be achieved by assessing the extent to which the proposed impact of the healthcare act has come to be realized five years since its implementation (Obama, 2016). Further, the study will also examine the extent to which the goals have been met. At the same time, the study will compare the anticipated implications of the act to the actual ones. These implications will be assessed in the form of the entire healthcare system and its stakeholders.

A comprehensive literature review will be carried out to gain an in-depth understanding of the effects of the ACA. This will be followed by a data section that will contain data sets that will provide the necessary numbers that will back the implications. The study will also entail a research section that carries out a detailed analysis of the evidence of the implications by assessing a total of nine major supporting materials. A summary of everything learned from this study will be conducted under a unified conclusion.

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Literature Review

Determining the effects of ACA is not an easy process. This can be attributed to the understanding that there are a significant number of factors that need to be taken into consideration. However, given that a reasonable amount of time has passed since its implementation, a lot of scholars, researchers, and critics have been able to carry out an adequate amount of work to determine the extent of the impact of the healthcare reform law. This has subsequently eased the process of examining the implications of this act. These implications will be assessed in the following review of literature consisting of a number of relevant sources.

The review will feature sources that explore the various ways that the ACA has impacted the healthcare sector and the transformation and changes that it has caused so far. Further, it will also entail the review of the impact of the Act on the stakeholders of this sector of the economy both in the short term based on the last five years and the long term impact. Consequently, the literature review is conducted in the following salient paragraphs as described in the bottom line.

The ACA has to a large extent recorded a significant amount of success in sharply increasing insurance coverage. According to Obama (2016), since this became law in 2010 the rate of the uninsured has decreased dramatically by 43 percent. The largest decline occurred following the requirements of the Act taking effect in 2014 (Obama, 2016). Schoonveld, Coyle, and Markham (2015) reiterate this in their study in which they postulate the number of the uninsured in the US declined from 49 million people to 29 million in the year 2015.

Further, they too make the admission that this is by far the largest decline witnessed since the creation of Medicare and Medicaid in the mid-1960s. From this decline, it is clear that the implication of the ACA in this regard is the transformation of the insurance industry and more significantly it has resulted in more people being able to access healthcare. There are various major coverage provisions of the law that have been credited for this increase in the number of insured. Obama (2016) cites provisions such as reforms in the insurance markets, financial assistance for individuals with low and moderate-income, and federal support for states to undertake an expansion of their Medicaid programs.

Schoonveld, Coyle, and Markham (2015) hold that the states that agreed to oversee the expansion of their Medicaid programs experienced larger reductions in their rates of people who were uninsured. Further, the provision of this healthcare reform act that allows children to remain under their parents’ plan until the age of 26 has also been a contributing factor to the high increase in the number of insured individuals throughout the country. The ACA in this regard has thus had a positive impact on the healthcare system.

Blumenthal, Abrams, and Nuzum (2015) also explore the concept of the impact of the ACA on insurance advance the notion that the ACA has fostered the emergence of retail-style health insurance. The implication of all is the evolution of the concept of exchanges. Consequently, the notion of public exchanges combined with the ACA’s excise duty has sparked a kind of the second perspective at private exchanges provided by employers. The assertion in this regard is that the increase in exchanges has the implication that insurers will become obligated to refine the manner in which they provide this retail experience. As a consequence, much more will need to be done.

Blumenthal, Abrams, and Nuzum (2015) in their assessment of the ACA five years after its implementation found that the healthcare reform law is raising the stakes for all healthcare players. In this regard, the ACA has resulted in the shifting of risk away from traditional insurers and onto providers. Manchikanti, Caraway, Parr, Fellows, and Hirsch (2011) share the same sentiments as they contend that today the risk for the cost of healthcare has been spread to also include hospitals, physicians, pharmaceuticals, companies, and consumers. This spread of risk can be attributed to the changes made in the payment process and the resulting financial incentives and penalties.

Blumenthal, Abrams, and Nuzum (2015) found that under the ACA the combined penalties for Medicare for instance places inpatient payments within this program to a risk of 5 percent. This demonstrates the extent to which the healthcare industry risk process has changed. Further, it shows some form of fairness given that risk is no longer concentrated on one side alone. This assessment can be perceived as positive for those who support risk sharing. Those stakeholders who for a long time have been benefiting from risk being borne by the consumer alone perceive this implication of the ACA a being negative.

Thus, in this regard, the beneficial nature of the suggested implications of ACA according to Blumenthal, Abrams, and Nuzum (2015) and Manchikanti, Caraway, Parr, Fellows, and Hirsch (2011) depends on the perception of the two sides. Various surveys demonstrate that a large number of those covered are satisfied with their current coverage. This, therefore, implies that the changes resulting from the ACA are meaningful.

Many critics of the ACA hold the claim that the healthcare reform law has paid limited attention to the element of revolutionizing the delivery of healthcare. However, Blumberg (2012) reveals in his study that a careful assessment of the law demonstrates that it represents an exceptional effort in the history of the US towards addressing the problems facing the healthcare sector. For this reason, Blumberg (2012) contends that the only criticism that can be made against this law is that it has tried too much. That is, the ACA has launched too many different initiatives and experiments, therefore, lacking a coherent strategy to implement its various reforms. Despite all this, the changes that this law has brought to the healthcare delivery cannot be ignored. The resulting implication is improved access to care by enhancing the process of care delivery. Therefore, patients are able to access healthcare at a fair price, in good time, and with increased efficiency.

 

Rosenbaum (2011) delved deeper into the influence of ACA in terms of the role it plays in the enhancement of healthcare delivery. This is through a review of specific provisions in the delivery system reform which are lumped in four main categories: change in government payment of healthcare; healthcare delivery organization; the policy of the workforce; and amendments toward the government becoming more innovative in pursue of long term reforms of healthcare (Rosenbaum, 2011). With regard to making changes to payment, the ACA has had the impact of accelerating the previous efforts of the federal government to change the payment system from the long term used volume-based and fee for service reimbursement to the provider’s performance.

Obama (2016) looks into this by covering the strategy of using incentives to cut down on Medicare readmissions. In this sense, the implication is that hospitals that are found to have a much higher than expected readmission rates of Medicare beneficiaries within a time frame of 30 days are heavily penalized. This is because this high rate implies the low performance of healthcare providers. The overall impact of this kind of initiative is that there has been a decline in the 30-readmission rates in the country (Rosenbaum 2011).

Within the category of organization of healthcare delivery, Rosenbaum (2011) assesses two critical concepts: Accountable Care Organizations (ACOs) and primary care transformation. First, the concept of accountable care organizations has the implication that healthcare providers can form new arrangements at the organizational level whose purpose is to facilitate the coordinated working of services such as the ambulatory, in-patients, and post-acute care services. Blumenthal, Abrams, and Nuzum (2015) also explore the concept of ACOs and opine that these kinds of organizations encourage healthcare providers to come together and take responsibility for the cost and quality of care they provide for a given Medicare beneficiaries population.

In this regard, these healthcare providers also share in the savings that come about as well. For instance, through this kind of arrangement, various physicians and hospitals can partner with each other to ensure better and more quality care and coordination. At the same time, it should be noted that the ACOs also demonstrate the impact of the ACA on healthcare stakeholders. Blumberg (2012) provides an example of how ACOs forces many pharmaceutical companies to respond to cost pressures. This response is through various health plans and risk-based demand.

Secondly, with respect to primary care transformation, the ACA impacts this through its support of various programs with the intention of improving this kind of care. Obama (2016) discusses the comprehensive primary care initiative which as an example of a program under the primary care transformation. Through this program, primary care providers are attempting to determine whether the use of innovative payment models is sufficient in controlling expenses while providing quality care. According to Rosenbaum (2011), initial evaluations of the program demonstrate that there has been a reduction in the amount of the monthly Medicare spending. Accordingly, the ACA is having a significantly positive impact on primary care. Despite this, the real test is in whether this kind of reduction can persist in the long term.

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Further, the implications of the ACA can also be assessed from the concept of the changes that it makes on workforce policy. Rosenbaum (2011) opines that the most notable area of focus among the various initiatives for employees under this healthcare reform law is the increase in the appeal of primary care and availing this to the Medicaid population. Despite this, Blumberg (2012) notes that one failure of the ACA has been in its inability to come up with a National Health Care Workforce Commission to oversee the policies that will control the general labor market of professionals in the healthcare sector.

When it comes to the government becoming more innovative Rosenbaum (2011) asserts the fact that since the government is responsible for the payment of close to 43 percent of the healthcare bill, it is vital to improving its innovative abilities. This will be critical in facilitating the government’s ability to adapt to the ever-changing health care environment such as the one brought about by the ACA.

Improving healthcare quality, efficiency, and accountability has also been the preoccupation of the ACA. This is a notion that is being driven forth by Manchikanti, Caraway, Parr, Fellows, and Hirsch (2011) who make the observation that the ACA acts to realign the healthcare system for the long term changes. These changes include aspects as healthcare quality, organization and policy of healthcare practice, and transparency in healthcare information (Manchikanti, Caraway, Parr, Fellows, & Hirsch, 2011). The ACA is able to achieve this by making a number of changes to the national healthcare programs of Medicare and Medicaid. These changes have facilitated the experimentation of new modes of payment and subsequent service delivery.

The resultant implications for this include manipulating the healthcare system is behaving in an improved way with the intention of urging the healthcare professionals to also improve their working behavior, determine the quality care and performance, and ensure quality improvement for chronic ailments. Similarly, Blumenthal, Abrams, and Nuzum (2015) also examine the ACA in terms of its ability to enhance the quality of healthcare and efficiency and consequently opine that this act invests in strategies for assessing quality and efficiency. One such strategy is the National Quality Strategy that provides various quality and efficiency measures that act to encourage value purchases, more safety, and increased information among both public and private insurers.

Data Section

To develop an in-depth understanding of the entire impact of the Patient Protection and Affordable Care Act on healthcare and stakeholders, several books and journals have been selected for this research. The books selected for this in-depth analysis are basically primary in nature with an emphasis on the Affordable Care Act in terms of the role it plays in improving the healthcare system and respective stakeholders such as patients, employees, the government, and the general population. One of the key elements that are covered in the books is the development of the Affordable Care Act and its commitment to ensuring that the healthcare sector is revolutionized through the provision of better services to consumers.

Another relevant aspect that has been covered in the books relates to the impact of the Patient Protection and Affordable Care Act in regard to the holistic healthcare system. In this regard, the books evaluate the degree to which access to healthcare among individuals drawn from different economic and racial backgrounds has access to insurance. The books explicate each of these points deeply hence giving a clear overview of the Act and the significant role that it has played in the improvement of the healthcare system.

The data sets that are used in this research include the level of health insurance coverage and the type of coverage as facilitated by the Patient Protection and Affordable Care Act. The type of coverage delves into the degree of coverage by sex and race of the individuals in the U.S.

  1. Essentially, the columns in the data set are made up of various elements with one of the major ones being the total number of people.
  2. The second column includes the total number of individuals covered by the government or private insurance.
  3. The third column entails individuals covered primarily by private health insurance.
  4. The fourth row involves health insurance for employment-based individuals.
  5. The fifth column covers the insurance under the direct purchase.
  6. The sixth column covers those under government health insurance.
  7. Additionally, the seventh column covers those under Medicaid while the eighth column covers those under Medicare.
  8. The two last columns cover health care for military servicemen and those not covered respectively.

In the rows, 2013 and 2014 are included as years to demonstrate the reforms that came into place with the introduction of the Act (The Data Set is Attached).

Research

In proving the findings of this research, one of the major books selected for this research is How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs? by three respected authors David I. Auerbach, Paul Heaton, and Ian Brantley. The book was published by the RAND Corporation. From the industrial perspective, this research is accepted and usable since there has been a commendable rise in the number of individuals accessing insurance hence boosting the level of health accessibility. The private coverage of individuals and Medicaid has increased significantly leading to major changes in the coverage of individuals (Auerbach, Heaton, & Brantley, 2014).

The book includes a continuation of research into the impact of the ACA into the healthcare system, as the authors appreciate the fact that little research has been done to understand the role of other providers who play a vital role in funding healthcare services such as the worker’s compensation union and the casualty insurers. In respect to shaping the healthcare industry, the ACA tends to affect the claim costs for these liability insurers. This impact is effectively anchored on diverse elements including the collateral source effect, the individual substitution effect, the direct fee effect, the medical malpractice volume effect, and the provider treatment effect. The effect of ACA on claim costs for liability insurers is as demonstrated in the table below.

Based on the table, it is clear that as a result of Act, the individual substitution effect in insurance payment has a -0 to -1.6 impact on the first party in the insurance claim. The impact is higher at this level. More so, the third party bears an increasing impact of 0 to -0.8 while the worker’s compensation will be affected by -0.1 to -1.2. (Auerbach, Heaton, & Brantley, 2014). However, there would be no effect on medical malpractice. In a general sense, the book brings out the view that as much as ACA has been accepted and is being used, it comes with some interesting trends for the entire healthcare industry including major downstream impacts on the insurance claim costs, which leads to the emergence of new pricing schemes for healthcare services a major increase in the individuals who are able to access the level of healthcare that is offered.

The second major source selected for this research is the article Understanding Disparities in Health Care Access – And Reducing Them – Through a Focus on Public Health by respected authors Kathryn Pitkin Derose, Carole Roan Gresenz, and Jeanne S. Ringel. The publisher of the article is also the RAND Corporation. In regard to the impact of ACA on the industry, the article discusses the above research by explaining the view that there has been a traditional level of disparities in access to healthcare among ethnic and racial minorities in the U.S. In line with the view of the article, ACA is accepted and properly utilized in terms of addressing the gap between the different races and minority groups in terms of access to healthcare (Derose, Gresenz, & Ringel, 2011).

Providers such as Medicaid have responded by taking the opportunity to offer coverage to populations hence boosting the level of access to healthcare services. State public agencies have also had a positive response to the effect of ACA through the development of linguistic and cultural competency among providers and the enforcement of regulatory approaches to encourage them to accommodate underserved populations and immigrants. Based on the article, the disparities in healthcare access could be instrumentally addressed by the Act in light of the following framework.

In line with the diagram, with the introduction of the Act the industry has gradually taken steps to boost the commitment of healthcare providers, improving their understanding of cultural aspects, and advocacy while at the same time boosting the capacity of the members of the population to pay for healthcare and develop trust in the providers of healthcare services (Derose, Gresenz, & Ringel, 2011). The overall impact in this regard has not been a rejection of the policy, but the improvement of the health and well-being of individuals that have shaped that perception of the minority in the healthcare system.

The third notable source selected to prove this research is the book Affordable Care Act: Obamacare by the respected author Kayla Murdock. The book was published by GRIN Verlag. By focusing on the whole concept of the system of healthcare and the changing trends, the book focuses on the uninsured Hispanics and how the Patient Protection and Affordable Care Act impacts them. Based on the book, the Act that was signed in 2010 has become instrumental in revolutionizing the healthcare industry especially with respect to the Hispanic population that has been widely uninsured previously (Murdock, 2012).

The findings with respect to the impact of the Patient Protection and Affordable Care Act were controversial as they pointed to the potential fines enforced by the Act on poor Hispanics who do not have the capacity to access and pay for insurance. There were also issues regarding the impact of the Act on curbing racial discrimination by physicians. Based on these controversies, a new product/approach developed to curb such differences include community-based agencies that offer Hispanics the opportunity to access health coverage and the development of programs for individuals with pre-existing medical conditions to access insurance coverage.

This sets the appropriate ground for universal access to healthcare services that are provided under the Act hence leading to a positive focus on the general industry of healthcare as an impartial sector when it comes to inclusion. From the book, further research is critical in order to understand the effectiveness of the Patient Protection and Affordable Care Act in covering all populations irrespective of their race and financial position (Murdock, 2012). Research in the future should focus on the tenets of the law and the populations that it targets to satisfy and meet their needs through its provisions. There would be increased satisfaction and access to healthcare with this approach in place.

Another high-level article relied on proving this research is the Evolution of Physician-Centric Business Models Under the Patient Protection and Affordable Care Act by respected authors Tanya Nix and Lynn Szostek. The article was published by Walden University. The in-depth study and explication of the Act were vital for the healthcare industry and were openly accepted and used in facilitating cheaper access to high standard healthcare across the U.S. The level of acceptance and subsequent rollout of the ACA was based on the trend of increasing costs of healthcare across the United States of America hence making it quite challenging for many individuals to access this necessary service. For instance, before the ACA, every American would have to spend at least $8,000 on medical carte per annum because of the high costs (Nix & Szostek, 2016).

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Such findings altered the perception of both providers and consumers of healthcare services toward ACA hence leading to wider appreciation and support for the quality services that is aimed at providing to them at any given moment. In fact, the most interesting thing about ACA is that it has advanced patient-centered healthcare where providers have been positive in their responses. They have effectively responded positively through the coordination of all the facets of the health of the patient with the view of ensuring that only high-quality healthcare services are delivered to the population.

The strategic movement from the physician-centric system of healthcare to a patient-centered approach has been quite critical in leading to the attainment of a high level of quality care among all individuals regardless of their racial and economic backgrounds. This was also critical in leading to the development of new products in the name of Accountable Care Organizations (ACO) that have continued to emphasize the delivery of reform in the healthcare industry (Nix & Szostek, 2016). The general effect of ACO has been the creation of better health outcomes for populations, the improvement of medical care, and the decrease in the growth of aggregate costs of healthcare for individuals.

The book Healthcare Politics and Policy in America by Kant Patel and Mark E. Ruthefsky was also selected to prove the research findings of this study. The book was published by M.E. Sharpe and is of a respectable nature in proving these findings. It delves into the politics surrounding the whole concept of the PPACA and the manner in which it came into place. The system of healthcare is quite difficult to reform and this could clearly be seen with the introduction of the Act (Patel & Rushefsky, 2014). As much as the government saw it as the best opportunity to give Americans the opportunity to access quality healthcare at affordable costs, other stakeholders and providers were not willing to adopt it hence posing a challenge to its success.

It has been fully accepted in some quarters especially by Democrats while it remains disputable among Republicans. The political shape that the whole matter took delayed its immediate application to the healthcare industry and significant functioning in the reduction of the costs of healthcare for the population. Nevertheless, the feedback from the industry providers took a positive direction through their common union, America’s Health Insurance Plans (AHIP), which plays the role of talking on behalf of all US health insurers made up of approximately 1,300 member companies (Patel & Rushefsky, 2014).

There was an ultimate continuation of research from the book with respect to achieving and adhering to some form of patient-centered care as opposed to nurse-centered care. In the general sense, there is clear evidence that there has been an increased number of people put under managed care plans and this has subsequently led to the rise in the number of Managed Care Organizations (MCOs) that ensure the spiraling healthcare costs among companies are curbed in the easiest manner possible.

The sixth source selected for the explication of the findings is The Affordable Care Act as a National Experiment: Health Policy Innovations and Lessons authored by Harry P. Selker and June S. Wasser and published by Springer. In line with the book, the ACA was widely accepted and used because of its standing as one of the most ambitious innovation in the healthcare system ever. There had never been a better approach to the mitigation of the rising costs as opposed to the ACA (Selker & Wasser, 2013). Its focus on expanding healthcare to tens of millions of additional citizens in the US is reflective of its objectivity and ultimate acceptance as health policy in the country.

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The providers of healthcare and insurance in the market were receptive to the research perceiving a revolutionary, innovative, and catalytic law that would ensure the ground is well hit in terms of moving ahead with the healthcare reforms. The acceptance is anchored on the understanding that the law has a clear direction of encouraging healthcare providers to adopt the role of providing exceptional care to everyone. There is an effort to reach the entire population so that those who fail to accept insurance coverage are fined appropriately. The element of further research that is taken from this book relates to the essence of the ACA with respect to expanding the population under insurance coverage.

As much as it targets to fine most members of the population who are not covered, there should also be a rationale of ensuring that the extent of coverage is increased through potential avenues such as advocacy that look at the whole healthcare system holistically (Selker & Wasser, 2013). The trend in the healthcare system in the U.S would become even more effective in instances where there is a balance in the number of individuals who are able to access insurance without any form of disparities that slow the process down.

The other major article that was utilized to prove the research is Population Health in the Affordable Care Act Era authored by Michael A. Stoto and published by AcademyHealth. The research in the article narrowed essentially on the population health as represented in the ACA. The research was acceptable and usable as it provides the view that population health is made up of individuals who are supposed to be covered under the healthcare system in the most satisfactory manner possible.

The findings in the article are not controversial in any particular manner as it clearly brings out the view that the adoption of the ACA has set the ground for fairness through the Accountable Care Organizations (ACO) (Stoto, 2013). To enhance the population health improvement, the article recommends the need to work in line with a framework that has a holistic focus on the individuals irrespective of their potential origins. The specific framework that is proposed by the research in the article is illustrated and described below.

From this model, the research emphasizes the need to facilitate equitable access to ensure that there is a balance in terms of accessing all individuals in the population in the course of delivering healthcare services (Stoto, 2013). The research makes sense for future studies by affirming that it is critical for the government and healthcare providers to continue closing the growing gap in the system by giving all categories of individuals access to insurance services. It would otherwise become more challenging to attain compliance with the current system. The major outcomes that would come as a result of this equality include the attainment of intermediate outcomes, improvement in the state of health, the rise in the quality of life, and an upstream rise in socio-economic factors across the country.

To clarify this research further, the article, The Stock Price Effect on the Affordable Care Act by Ronald A. Stunda was also chosen as a major article for this area of study. The article is a publication of the Global Journals Inc. The article narrows down on the effect of the ACA on the stock prices of insurance in the healthcare industry. The focus is also in 2012 when the ACA took effect with respect to shaping the healthcare sector (Stunda, 2014).

The research findings are acceptable because they reflect the significant effect that the ACA has with respect to lowering the stock prices and earnings by firms in the healthcare industry. The providers of health took these results with a negative perspective in the first instance because of the feeling that they were going to encounter losses once the ACA became law. In this empirical study, the stock effect of the ACA was illustrated with research into several companies, and the results indicated as in the table below hence showing the downward pressure of its adoption. The table is illustrated and explained below.

In line with the above table, it is demonstrated that the effect on stock prices is high as they go down after the adoption of the ACA. This is one of the key elements that led to the adoption and use of this research for the explication of the changing impacts of the ACA on patients populations and racial minorities (Stunda, 2014). There was no new product recommended in the study, but room for future research that focuses on the experiences of specific industries such as those dealing with insurance to offer the desired services to their consumers.

The last major article selected for the explication of the results is The Patient Protection and Affordable Care Act: The Latest Obstacle in the Path to Receiving Complementary and Alternative Health Care? authored by Chelsea Stanley and published by Indiana University. The research findings in the article effectively shape the healthcare industry by revealing the effectiveness of the ACA in increasing the level of coverage for individuals while at the same time putting into consideration the quality of health that they are expected to receive. Providers of healthcare received the findings with much positivity given the fact that the government will be in a better position to subsidize low-income earners hence allowing them to access better health care (Stanley, 2015).

Other wealthier taxpayers could play a vital role in making these subsidies a success for individuals in need of insurance and better medical attendance. However, the results tended to bring to light some controversies with the assertion that states are responsible for subsidizing treatments that are necessary but not perceived as important health benefits for individuals who cannot afford to pay the premiums. The question of controversy regarded the need of subsidizing such diseases when not recognized in the federal health system (Stanley, 2015).

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They need to be at least backed up by the federal government for them to be comfortably subsidized. The future research that is pointed out in the article relates to the impact of the ACA on both licensed complementary and alternative medical practitioners. It would be critical to establishing whether there would be a positive or negative impact on their performance of duties based on the existence of the Act.

Conclusion

In summary, this work has provided a significant learning platform. One of the key lessons from this research is that the passing of the Patient Protection and Affordable Care Act was vital in shaping the healthcare industry in the U.S by boosting the accessibility to healthcare among all members of the population. It ensures that individuals from low-income families are effectively subsidized hence accessing quality healthcare at the most affordable costs possible. The second lesson in the course of this research is that the ACA also faces its own controversies with respect to imposing fines on individuals who are not covered by insurance.

As much as it advocates for the need to have universal access to healthcare, it tends to overlook the fact that employers cannot always pay premiums for their employees at all times. This tends to be its downside in the course of promoting access to healthcare. The third notable lesson from this research is that the entire topic of the Affordable Care Act has been widely researched by influential researchers who have delved into its impacts on both providers and stakeholders of the healthcare.

There are varying views from these studies, but they all tend to come to the agreement that ACA has reformed healthcare to a great extent by ensuring equality in access to healthcare among individuals. The system is currently patient-centered and this ensures that all the focus is placed on the well-being of patients. Even as the focus is placed on patients, there is an issue of forgetting physicians and nurses who are also primary stakeholders in the healthcare system. It would be more recommendable to have a system that accommodates their position and welfare in the future.

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